Étude de l’évolution cognitive, socio-émotionnelle et des comportements autistiques d’enfants avec autisme et autre trouble envahissant du développement bénéficiant d’une intervention structurée, la méthode Applied Behavior Analysis (ABA)

Abstract

ContextRecommendations of the Great Health Authority (HAS, 2012) indicate that children with autism and other pervasive developmental disorders have to benefit of scientifically validated behavioral and developmental structured interventions as early as possible, such as for example Applied Behavior Analysis (ABA). In this context, this not randomized and with no controlled group longitudinal study aims at confirming the interest of the behavioral approach ABA intervention for children with autism (n=10) cared in a Parisian educational establishment dedicated to autism. ObjectiveTo examine the evolution of both their cognitive and socio-emotional development and autistic behaviors with validated and appropriated tests and scales (PEP 3, BECS, EDEI-R ; BSE-R, BFE) proposed three times (T1, T2 and T3) over a period of 20 months and at intervals of 10 months between T1 and T2 and T2 and T3. The children of this study are examined by expert psychologists external to the establishment. HypothesisIt is postulated that there is both an increasing in cognitive and socio-emotional development domains and a decreasing in autistic behavior. Moreover, it was hypothesized that the developmental and behavioral progresses are better for youngest children and for these ones who have a best development level at the beginning of the intervention. ParticipantsTen children with autism (n=8) and other pervasive developmental disorders (n=2) were included. They were aged from 4 years and 2 months to 11 years and 1 month of age. Diagnosis was carried out with DSM-IV-TR criteria and CARS by specialist practitioners and psychiatrists. Nine children on 10 exhibited a developmental delay and for those who were mentally retarded, the degree of severity of delay was variable (Global Developmental Quotient: from 21 to 57). All these children benefit of ABA method five days a week, which is provided by specially trained educators who were coached and supervised by a psychologist “BCBA-Board Certified Behavior Analyst”. ResultsThe cognitive, socio-emotional and behavioral evolution of these 10 children was overall good over period of 20 months, variable and heterogeneous from one child to another and rather not regular to under-period to another. The autistic symptomatology decreased after 8 months of intervention (between T1 and T2) and after 20 months of intervention (between T1 and T3). Moreover, higher is the developmental age at the beginning of intervention higher is the motor development after 20 months of intervention (between T1 and T3). DiscussionFocusing on the interest of the ABA intervention, this study permits to confirm that children with autism and intellectual deficiency progress in cognitive and socio-emotional domains and that their autistic symptomatology decrease.